Medical manipulator

Abstract

A medical manipulating device (1), in particular, for endoscopic applications, having a medical instrument (3) disposed at the distal end, a grip (2) disposed at the proximal end, the grip (2) being provided with a grasping part (4) which can be held by hand, the grasping part (4) being provided with actuating elements which can be operated with the fingers, and a shank part (5), which connects the grip (2) to the instrument (3), and which is provided with transmission elements which transmit actuation of the actuating elements to the medical instrument (3).

What is claimed is: 
     
       1. A medical manipulating device (1) having a medical instrument (3) disposed at a distal end of the manipulating device,   a grip (2) disposed at a proximal end of the manipulating device, said grip (2) being provided with a grasping part (4) which can be held by the hand, said grasping part (4) being provided with actuating elements which can be operated with fingers of the hand, and   a shank part (5), which connects said grip (2) to said instrument (3), and which is provided with transmission elements which transmit actuation of said actuating elements to said medical instrument (3); the improvement comprising:     said grasping part (4) is ergonomically shaped to be grasped between a ball of the hand and a first row of the phalanges of the fingers and to be held without use of at least a third and second phalange of index and middle fingers of the hand, and wherein said grasping part (4) is designed multipartite with exchangeable and different size parts being provided to match different hands, and   a separate actuating element is provided for at least the index finger and the middle finger respectively, each said actuating element being designed in such a manner that upon being actuated with a free finger tip of the assigned finger, the rest of the hand and the fingers remain in a grasping position.   
     
     
       2. A manipulating device according to claim 1, characterized by said transmission elements being designed for proportional transmission of the actuation motion. 
     
     
       3. A manipulating device according to claim 2, characterized by said actuating elements being designed in such a manner that their position indicates the position of a swiveling axis assigned to at least one said actuating elements for said medical instrument. 
     
     
       4. A manipulating device according to claim 2, characterized by said actuating elements being selected from a group comprising analog tabs, rocker keys, analog electric control elements analog swivel keys, and combination of these. 
     
     
       5. A manipulating device according to claim 1, characterized by said actuating elements being pressable with the respective finger tip against a restoring force. 
     
     
       6. A manipulating device according to claim 1, characterized by at least one separate actuating element being provided for a thumb of the hand, said separate actuating element selected from a group comprising a press button key (24), a swivel key, a rocker key, and a rotary element (17). 
     
     
       7. A manipulating device according to claim 6, characterized by multiple actuating elements which can be selectively operated with the thumb. 
     
     
       8. A manipulating device according to claim 1, characterized by said shank part (5) being connected to said grasping part between the actuating elements for the index finger and the middle finger. 
     
     
       9. A manipulating device according to claim 8, characterized by said shank part (5) configured to be disposed approximately as a straight extension of an outstretched underarm of the hand. 
     
     
       10. A manipulating device according to claim 1, characterized by said actuating elements being selected from a group providing opening motions, closing motions, rotary motion and combinations of these to said medical instrument (3). 
     
     
       11. A manipulating device according to claim 1, characterized by said manipulating device (1) being provided with at least one fluid connection. 
     
     
       12. A manipulating device according to claim 1, characterized by at least one of said actuating elements being coupled to a lock-in device for locking the one of said actuating elements in at least one position. 
     
     
       13. A manipulating device according to claim 1, characterized by a clamping means (9) configured to be disposed on said grasping part in the region between a thumb and the first row of phalanges of a index finger of the hand. 
     
     
       14. A manipulating device according to claim 1, characterized by said grasping part being provided with molded grooves (10) and raised separation means (28). 
     
     
       15. A manipulating device according to claim 1, characterized by a support (11) being provided on the grasping part (4) for a thumb of the hand. 
     
     
       16. A manipulating device according to claim 1, characterized by said medical instrument (3) being borne on said shank part (5) in a rotatable manner about a longitudinal axis of said shank part (5), in said shank part (5) a shaft being provided which runs through said shank part (5) in a longitudinal direction and a distal end of said shaft being connected to said medical instrument (3) in a non-rotatable manner, and said shaft being connected to an actuating element provided at said grasping part (4) in a driving manner. 
     
     
       17. A manipulating device according to claim 16, characterized by said shaft being coupled via a transmission to a rotary element disposed on the grasping part (4). 
     
     
       18. A manipulating device according to claim 17, characterized by said shaft being guided in an axially shiftable manner in said shank part (5) to transmit an adjustment motion of said medical instrument (3). 
     
     
       19. A manipulating device according to claim 18, characterized by said shaft being designed as a hollow shaft (13), and in an internal longitudinal cavity thereof a transmission element being provided for longitudinal forces. 
     
     
       20. A manipulating device according to claim 1, characterized by in said shank part (5) at least one conduit being provided for fluid. 
     
     
       21. A manipulating device according to claim 1, characterized by said grasping part being disassemblable for cleaning. 
     
     
       22. A medical manipulating device (1) having a medical instrument (3) disposed at a distal end of the manipulating device;   a grip (2) disposed at a proximal end of the manipulating device, said grip (2) being provided with a grasping part (4) which can be held by the hand, said grasping part (4) being provided with actuating elements which can be operated with fingers of the hand, and   a shank part (5), which connects said grip (2) to said instrument (3), and which is provided with transmission elements which transmit actuation of said actuating elements to said medical instrument (3); the improvement comprising:     said grasping part (4) is ergonomically shaped to be grasped between a ball of the hand and a first row of the phalanges of the fingers and to be held without use of at least a third and second phalange of index and middle fingers of the hand;   a separate actuating element is provided for at least the index finger and the middle finger respectively, each said actuating element being designed in such a manner that upon being actuated with a free finger tip of the assigned finger, the rest of the hand and the fingers remain in a grasping position; and   an actuating button (26) which can be swiveled laterally in at least two directions being provided on said grasping part (4).   
     
     
       23. A manipulating device according to claim 22, characterized by said actuating button (26) being swivelable in all directions and multiple, transmission elements being provided which are 90 degrees offset to each other on said actuating button. 
     
     
       24. A medical manipulating device (1) having a medical instrument (3) disposed at a distal end of the manipulating device,   a grip (2) disposed at a proximal end of the manipulating device, said grip (2) being provided with a grasping part (4) which can be held by the hand, said grasping part (4) being provided with actuating elements which can be operated with fingers of the hand, and   a shank part (5), which connects said grip (2) to said instrument (3), and which is provided with transmission elements which transmit actuation of said actuating elements to said medical instrument(3); the improvement comprising:     said grasping part (4) is ergonomically shaped to be grasped between a ball of the hand and a first row of the phalanges of the fingers and to be held without use of at least a third and second phalange of index and middle fingers of the hand; and   a separate actuating element is provided for at least the index finger and the middle finger respectively, each said actuating element being designed in such a manner that upon being actuated with a free finger tip of the assigned finger, the rest of the hand and the fingers remain in a grasping position;   said grasping part being provided with molded grooves (10) for receiving fingers therein and raised separation means (28) for separating adjacent fingers.